The relationship between health literacy, knowledge of health status, and beliefs about HIV/AIDS transmission among Ryan White clients in Miami

Objective: The aim of this study was to examine the relationships between health literacy, knowledge of health status, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) transmission beliefs among recipients of Ryan White care. Design: Quota and convenience sampled, quantitative analysis captured with closed and open-ended interviews. Setting: Miami-Dade County health organizations in which Ryan White-funded medical case management services were offered. Method: A total of 694 clients were interviewed about their satisfaction with services they were receiving at the case management sites, and whether they received or read any educational materials about the HIV/AIDS virus and their health. Interviews also asked clients to complete the Rapid Estimate of Adult Literacy in Medicine, Short Form (REALM-SF), to give their viral load and cluster difference (CD) 4 counts, and about their beliefs regarding how HIV/AIDS is transmitted. Results: Most clients reported receiving and/or reading educational materials about HIV/AIDS; however, 42% of clients had a health literacy level below high school. More than one-third of clients were unable to give their CD4 count or viral load figure, and one-third also held incorrect beliefs about how the virus is transmitted. Additionally, health literacy was the only predictor of whether or not clients held incorrect transmission beliefs. Conclusion: These results highlight the need for case managers and other health service providers to screen clients for health literacy and communicate with their clients accordingly. Providers should be proactive with clients and utilize multiple approaches when presenting client health indicators and educational information to ensure the client not only can repeat the information, but that they also comprehend it.